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The Tennessee State Department of Health and CDC are collaborating with public health officials in multiple states and the U.S. Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) to investigate an ongoing multistate outbreak of E. coli O157:H7 infections in humans. A study comparing foods eaten by ill persons to foods eaten by well persons showed that eating frozen pizza that contained pepperoni and was produced by the General Mills company under the brand names of Totino's or Jeno's was the likely source of the illness.

As of November 1st, at least 21 isolates of E. coli O157:H7 with an indistinguishable genetic fingerprint have been collected from ill persons in 10 states: Illinois (1 person), Kentucky (3), Missouri (2), New York (2), Ohio (1), Pennsylvania (1), South Dakota (1), Tennessee (8), Virginia (1), and Wisconsin (1). Persons became ill between July 20, 2007, and October 10, 2007. The age of ill persons ranges from 1 to 65 years with a median age of 9; 53% of ill persons are female. At least 8 people have been hospitalized, and 4 have developed a type of kidney failure known as hemolytic-uremic syndrome, or HUS. No deaths have been reported.

States with Outbreak-Associated Cases of E. coli O157, October 2007

The Tennessee State Department of Health, working with CDC and health officials in several other states, coordinated a study to identify the source of these infections. Eating a Totino's or Jeno's brand frozen pizza containing pepperoni was significantly associated with illness. The source of contamination of the pizzas is not known at this time. Company officials are working closely with CDC, USDA-FSIS, the Food and Drug Administration (FDA), and state health and agricultural departments to identify the source of the contamination. General Mills has ceased shipment of all frozen pizza products that contain pepperoni and has announced a voluntary recall.

Most people infected with E. coli O157:H7 develop severe bloody diarrhea and abdominal cramps 2-8 days (average of 3-4 days) after infection. Infection is usually diagnosed by culture of a stool sample. Most people recover completely within 5-10 days, although some people, particularly young children and the elderly, are at increased risk for severe illness. In severe infection, E. coli O157:H7 can cause a type of kidney failure known as hemolytic uremic syndrome, or HUS.

Consumers should not eat recalled Totino's or Jeno's brand frozen pizzas that contain pepperoni as a topping. Anyone who has eaten the product but did not become ill need not take any special action. People who are ill with diarrhea within a week of consuming this type of frozen pizza should seek medical care and let their doctor know about the exposure. Consumers with questions about the recall should contact the company at 1-800- 949- 9055. Representatives will provide information about how to contact the company for a full refund. Consumers are reminded to always thoroughly cook all products that are not ready-to-eat, such as frozen pizzas, according to package instructions.